Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools
<i>Background and objectives</i>: Exertional heat stroke (EHS) continues to be a prevalent health issue affecting all athletes, including our pediatric populations. The purpose of this study was to evaluate the effect of a state policy requirement for EHS prevention and treatment on loca...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-09-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/56/10/488 |
| _version_ | 1797728175390720000 |
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| author | Samantha E. Scarneo-Miller Benjamin Saltzman William M. Adams Douglas J. Casa |
| author_facet | Samantha E. Scarneo-Miller Benjamin Saltzman William M. Adams Douglas J. Casa |
| author_sort | Samantha E. Scarneo-Miller |
| collection | DOAJ |
| description | <i>Background and objectives</i>: Exertional heat stroke (EHS) continues to be a prevalent health issue affecting all athletes, including our pediatric populations. The purpose of this study was to evaluate the effect of a state policy requirement for EHS prevention and treatment on local high school policy adoption in the United States (US). <i>Materials and Methods</i>: Athletic trainers (ATs) from high schools across the US participated in an online survey (<i>n</i> = 365). This survey inquired about their compliance with nine components of an EHS policy which was then compared to their state requirements for the policies. Evaluation of the number of components adopted between states with a requirement versus states without a requirement was conducted with a Wilcoxon Sign Rank test. Finally, an ordinal logistic regression with proportional odds ratios (OR) with 95% confidence intervals (CI) were run to determine the effect of a state requirement and regional differences on the number of components adopted. <i>Results</i>: ATs working in states with a requirement reported adoption of more components in their heat modification policy compared to states that did not require schools to develop a heat modification policy (with requirement mean = 5.34 ± 3.68, median = 7.0; without requirement mean = 4.23 ± 3.59, median = 5.0; <i>Z</i> = −14.88, <i>p</i> < 0.001). ATs working in region 3 (e.g., hotter regions) reported adopting more components than those in region 1 (e.g., cooler regions) (OR = 2.25, 95% CI: 1.215–4.201, <i>p</i> = 0.010). <i>Conclusions</i>: Our results demonstrate a positive association between state policy requirements and subsequently increased local policy adoption for EHS policies. Additionally, the results demonstrate that regional differences exist, calling for the need for reducing disparities across the US. These findings may imply that policy adoption is a multifactorial process; furthermore, additional regional specific investigations must be conducted to determine the true determinants of high school policy adoption rates for EHS policies. |
| first_indexed | 2024-03-12T11:10:05Z |
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| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T11:10:05Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-00ef293c0d304894ac75c32fa5ba51fa2023-09-02T02:55:51ZengMDPI AGMedicina1010-660X2020-09-015648848810.3390/medicina56100488Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High SchoolsSamantha E. Scarneo-Miller0Benjamin Saltzman1William M. Adams2Douglas J. Casa3Division of Athletic Training, School of Medicine, West Virginia University, Morgantown, WV 26508, USAKorey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USAHeat, Environment and Thermal Stress Lab, Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC 27412, USAKorey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA<i>Background and objectives</i>: Exertional heat stroke (EHS) continues to be a prevalent health issue affecting all athletes, including our pediatric populations. The purpose of this study was to evaluate the effect of a state policy requirement for EHS prevention and treatment on local high school policy adoption in the United States (US). <i>Materials and Methods</i>: Athletic trainers (ATs) from high schools across the US participated in an online survey (<i>n</i> = 365). This survey inquired about their compliance with nine components of an EHS policy which was then compared to their state requirements for the policies. Evaluation of the number of components adopted between states with a requirement versus states without a requirement was conducted with a Wilcoxon Sign Rank test. Finally, an ordinal logistic regression with proportional odds ratios (OR) with 95% confidence intervals (CI) were run to determine the effect of a state requirement and regional differences on the number of components adopted. <i>Results</i>: ATs working in states with a requirement reported adoption of more components in their heat modification policy compared to states that did not require schools to develop a heat modification policy (with requirement mean = 5.34 ± 3.68, median = 7.0; without requirement mean = 4.23 ± 3.59, median = 5.0; <i>Z</i> = −14.88, <i>p</i> < 0.001). ATs working in region 3 (e.g., hotter regions) reported adopting more components than those in region 1 (e.g., cooler regions) (OR = 2.25, 95% CI: 1.215–4.201, <i>p</i> = 0.010). <i>Conclusions</i>: Our results demonstrate a positive association between state policy requirements and subsequently increased local policy adoption for EHS policies. Additionally, the results demonstrate that regional differences exist, calling for the need for reducing disparities across the US. These findings may imply that policy adoption is a multifactorial process; furthermore, additional regional specific investigations must be conducted to determine the true determinants of high school policy adoption rates for EHS policies.https://www.mdpi.com/1010-660X/56/10/488best practiceadoptionpolicy and procedureexertional heat strokepreparationregional differences |
| spellingShingle | Samantha E. Scarneo-Miller Benjamin Saltzman William M. Adams Douglas J. Casa Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools Medicina best practice adoption policy and procedure exertional heat stroke preparation regional differences |
| title | Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools |
| title_full | Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools |
| title_fullStr | Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools |
| title_full_unstemmed | Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools |
| title_short | Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools |
| title_sort | regional requirements influence adoption of exertional heat illness preparedness strategies in united states high schools |
| topic | best practice adoption policy and procedure exertional heat stroke preparation regional differences |
| url | https://www.mdpi.com/1010-660X/56/10/488 |
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